To review the literatures on the treatment of sleep disorder with acupuncture and moxibustion in China in recent years. we believed that combined acupuncture and medicine, acupuncture and auricular acupuncture had obvious advantages in the treatment of sleep disorder after stroke.

There are several main topics in acute myelogenous leukemia at the 57th American Society of Hematology annual meeting, including the optimization about induction and consolidation chemotherapy for AML, the investigation of targeted drugs in AML first line therapy, the marker for AML MRD monitoring, the differentiation drugs, such as tamibarotene in APL, the definition about refractory AML, the induction therapy for blastic plasmacytoid dendritic cell neoplasm (BPDCN). This article reviewed the research progress of AML in the 57th ASH annual meeting.

Objective To evaluate the clinical efficacy and safety of iMliximab (IFX) in the treatment of Crohn's disease (CD).Methods From February 2009 to March 2013,the clinical data of 62 CD patients with IFX treatment were retrospectively analyzed.At week 14th after IFX injection and the end of follow-up of this study (March 2013) were two observation points.At week 14th after IFX injection (three times of IFX injection),C reactive protein (CRP) level,Crohn's disease activity index (CDAI) score and clinical remission were investigated.At the end of follow-up,clinical remission,fistula closure,mucosal healing and side effects were inspected.Normal distribution data were expressed as 2±s,which were compared with t test.Non normal distribution data were expressed as M (QL-QU) and compared with Wilcoxon test.Results Four cases without complete three times of IFX injection and one case lost to follow-up were eliminated.And nine postoperation cases with IFX treatment to prevent recurrence after surgery were excluded.A total of 48 cases of CD in active period were enrolled in this study on efficacy.At week 14th,CRP level of 48 patients [1.9(0.5,5.4) mg/L]decreased compared with that before treatment [28.9(6.4,51.1) mg/L] (Z=-5.468,P＜0.01);CDAI score (87.0±35.8) also decreased compared with that before treatment (245.1±59.1) (t=18.579,P＜0.01).At week 14th,46 patients in active period achieved clinical remission and the remission rate was 95.8％.By the end of follow-up,38 patients were still in remission period and the remission rate was 79.2％.Among 26 patients with anal fistula before IFX treatment,seven cases (26.9％) were completely closed,17 cases (65.4％) was partially closed and two cases was responseless.Fifteen patients were reviewed by colonoscopic examination after more than six times of IFX treatment.The median of simple endoscopic score for Crohn's disease (SES-CD) was 3 (0,5)after treatment,which decreased compared with that before treatment (8(7,9),Z=-3.306,P=0.001).Twenty-two of 48 cases in active period received,step-up strategy and 26 cases received with top-down strategy.At week 14th,20 cases (90.9％) of group with step-up strategy and 26 cases (100.0％) of group with top-down strategy were in remission period.By the end of follow-up,14 cases (63.6％) of group with step-up strategy and 24 cases (92.3％) of group with top down strategy maintained remission.Among 26 cases with anal fistula,two cases without response were treated with step-up strategy and seven cases with complete closure were all with top-down strategy.Among 62 patients,five had side effects,three of whom had acute infusion reaction,one had delayed infusion reaction and the other had anemia.Conclusions IFX had good clinical efficacy in controlling inflammation,inducing clinical remission,promoting fistula closure and mucosal healing in CD patients.For some CD patients with high risk,the initial top-down strategy showed good clinical efficacy.

Acupuncture Therapy ; Acute Disease ; therapy ; Humans ; Male ; Middle Aged ; Spasm ; therapy ; Stomach Diseases ; therapy

Objective:The paper aims to evaluate the impacts of the urban residents’ basic medical insurance on the medical treatment and preventive care services utilization through quantitative evaluation. Methods:The China Health and Nutrition Surveys ( CHNS) Data collected from 2006 to 2011 were used to compare the difference between medical treatment and preventive care services utilization adopting the difference-in-difference method and the Probit model. The control group urban residents did not participate in the basic medical insurance while their treatment group participated. Results:The medical treatment and preventive care services utilization were more for the treat-ment group than they were for the control one. The age, education level, annual per capita income and hypertension influenced the medical services utilization, and the annual per capita income was a protective factor. The age and ed-ucation level also influenced the preventive care services utilization. Conclusion: The urban resident basic medical insurance plays an important role in the medical treatment and preventive care services utilization. Meanwhile, this factor continuously enhanced the coverage and the per capita income protection for medical services.

Post stroke depression (PSD) is a common complication after senile cerebrovascular diseases. It influences both physical and mental health of the elderly severely. So, the attention should be paid to not only the medical cares but also the function and mental rehabilitation, in order to improve the qualities of PSD patients' lives and decrease the death rate.

Objective We conducted a systematic review and meta-analysis of the published literature to evaluate the efficacy of prophylactic antibiotics in the prevention of incisional infection of inguinal tension-free hernioplasty.Methods Articles of randomized controlled trials about the efficacy of prophylactic antibiotics in the prevention of incisional infection in the inguinal tension-free hernioplasty published from January 1975 to October 2012 was retrieved and systematically reviewed.Results A total of 11 randomized controlled trials meeting the inclusion criteria were screened.Among the 4159 cases of patients,130 cases had wound infection,and the infection rate was 3.13％.In the prophylactic antibiotics group of 1845 cases,wound infection occurred in 45 cases; the infection rate was 1.94％.In the control group of 2314 cases,85 cases had incision infection; the infection rate was 3.67％.The preventive use of antimicrobial drugs reduced surgical site infection of inguinal tension-free hernioplasty (OR 0.55,95％ CI 0.38-0.80,P =0.002).Conclusions The use of prophylactic antibiotics can effectively reduce the incisional infection in the inguinal tension-free hernioplasty.

Aim To investigate the effects of CYP2C19 polymorphism on the pharmacokinetics and comparative bioavailability of omeprazole in Chinese population.Methods Eighteen healthy male volunteers were selected,of whom 6 were CYP2C19 wild type(w/w),6 were CYP2C19 heterozygous variant(w/m) and the rest were CYP2C19 homozygous variant(m/m).A randomized two-period crossover study was performed.Subjects were assigned to receive test or reference omeprazole as a single oral dose of 40 mg randomly.After a washout period of one week,subjects received the alternative omeprazole formulation.Multiple blood samples of 3 ml were obtained over 12 h after dosing and plasma concentrations of omeprazole were measured by LC/MS method.The modeling of individual pharmacokinetics and the pharmacokinetic parameters of omeprazole were estimated by 3P97.Results The AUC and Cmax of reference omeprazole formulation in w/w,w/m,m/m groups were 1178.44±340.24,2328.10±1011.83,5062.02±1097.29 μg·h·L~(-1) and 602.87±118.25,926.43±134.48,1406.29±233.58 μg·L~(-1),respectively,with significant differences among the three groups(P<0.05).Significant differences were also observed in other pharmacokinetic parameters such as k_e、CL/F、t_(1/2) and Vd/F among the three groups(P<0.05).With regard to test omeprazole formulation,the AUC and C_(max) in w/w,w/m,m/m groups were 1224.82±531.67,2723.34±519.29,5692.49±1575.35 μg·h·L~(-1) and 618.74±231.43,910.67±125.99,1303.31±152.01 μg·L~(-1),respectively,which,as well as k_e,CL/F,t_(1/2) and Vd/F were significant different among the three groups(P<0.05).No significant differences were observed in comparative bioavailability among groups with the values of 94.29%±14.06%,93.08%±11.22%,91.84%±13.03% in w/w,w/m,m/m groups respectively(P>0.05).Conclusions Different CYP2C19 genotypes,leading to functional heterogeneity of CYP2C19,may affect pharmacokinetic profile of omeprazole.Therefore,genotyping CYP2C19 gene before omeprazole therapy will be of great benefit for optimizing individual therapy regimen.There is no significant difference of omeprazole comparative bioavailability with regard to CYP2C19 genetic polymorphism.

Objective To explore the research progress of the multimodal clinical support system (CSS). Methods With recognized development and operation of the multi-model CSS, and compared to the traditional CSS, to explore the research progress of the multimodal CSS. Results Based on the realization of the concept, purpose and characteristics of the multimodal CSS, it has been known that the international research progress of the multimodal CSS. Conclusion The developing and evolving of the CSS model have offered a new assist to the multi-disciplinary treatment model, and have enhanced the improving system associated with the practice of evidence-based medicine. However, the application of clinical support system program (CSSP) in our country still needs more research.

Arsenic and its species in dry seafood products(DSPs) Kelp, Sargassum fusiform, Laver, Enteromorpha prolifera, were systematically determined by high performance liquid chromatography-inductively coupled plasma mass spectrometry(HPLC-ICP-MS). It was found that the of arsenic species in botanic DSPs are three unknown arsenicals(U_2, U_3 and U_4), which are speculated as arsenosugars and take approximate 63.5% 92.7% of all arsenic species detected. These arsenosugars were indentified as dimethylarsinic(DMA)-glycerol ribose, DMA-phosphate ribose and DMA-sulfate ribose by their accuracy molecular weight 329.0599, 483.0738 and 409.0162, using direct confirmatory of HPLC-TOF-MS. The quantitative analysis of these arsenic species shows that although the total arsenic exceeds the National Standard value, most of the marine plants DSPs are safe to eat. The main component in most marine plants is DMA-sulfate ribose(51.1%-80.3%), while the main component of Kelp is DMA-phosphate ribose(48.9%). The sum of those three arsenosugars was 63.5%-92.7% of peak areas in all arsenic species detected.